Parker Romy, Higgins Zeenath, Mlombile Zandiswa N P, Mohr Michaela J, Wagner Tarryn L
Department of Anaesthesia and Perioperative Medicine, University of Cape Town, South Africa.
Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa.
S Afr J Physiother. 2018 Aug 28;74(1):442. doi: 10.4102/sajp.v74i1.442. eCollection 2018.
Chronic fatigue syndrome (CFS) is a central sensitisation syndrome with abnormalities in autonomic regulation of blood pressure (BP), heart rate (HR) and heart rate variability (HRV). Prior to exploring the effects of hydrotherapy as a treatment for this population, changes in BP, HR and HRV during warm water immersion need to be established.
The study aimed to determine the effects of warm water immersion on BP, HR and HRV in adults with CFS compared to matched-pair healthy adults.
A quasi-experimental, single-blinded study design was used with nine CFS participants and nine matched controls. Participants' BP, HR and HRV were measured before, after 5 minutes and post warm water immersion at the depth of the fourth intercostal space, using the Ithlete® System and Dräger BP monitor.
There was a significant difference between groups in HRV prior to immersion (control group: 73 [55-74] vs. chronic fatigue syndrome group: 63 [50-70]; = 0.04). There was no difference in HRV post-immersion. A significant difference in HR after immersion was recorded with the control group having a lower HR than those with CFS (78 [60-86] vs. 86 [65-112]; = 0.03). The low HRV present in the CFS group prior to immersion suggests autonomic dysregulation. Individuals with CFS may have reduced vagal nerve activation post-immersion. During immersion, HRV of the CFS participants improved similar to that of the healthy controls.
Prior to immersion, differences were present in the HRV of the participants with CFS compared to healthy controls. These differences were no longer present post-immersion.
Warm water immersion appears safe and may be beneficial in the management of individuals with CFS.
慢性疲劳综合征（CFS）是一种中枢敏化综合征，在血压（BP）、心率（HR）和心率变异性（HRV）的自主调节方面存在异常。在探索水疗作为该人群治疗方法的效果之前，需要确定温水浸泡期间血压、心率和心率变异性的变化。
本研究旨在确定与配对的健康成年人相比，温水浸泡对CFS成年患者的血压、心率和心率变异性的影响。
采用准实验、单盲研究设计，纳入9名CFS参与者和9名配对对照。使用Ithlete®系统和德尔格血压监测仪，在第四肋间深度进行温水浸泡前、浸泡5分钟后以及浸泡后测量参与者的血压、心率和心率变异性。
浸泡前两组的心率变异性存在显著差异（对照组：73[55 - 74]，慢性疲劳综合征组：63[50 - 70]；P = 0.04）。浸泡后心率变异性无差异。浸泡后记录到心率存在显著差异，对照组的心率低于CFS患者（78[60 - 86]对86[65 - 112]；P = 0.03）。CFS组浸泡前存在的低心率变异性提示自主神经调节异常。CFS患者浸泡后迷走神经激活可能降低。浸泡期间，CFS参与者的心率变异性改善情况与健康对照组相似。
浸泡前，CFS参与者的心率变异性与健康对照组存在差异。浸泡后这些差异不再存在。
温水浸泡似乎是安全的，可能对CFS患者的管理有益。
